100 cases in surgery PDF
Preview 100 cases in surgery
1 Second edition A 64-year-old woman has been referred to the on call general 0 surgical team by her GP. She has been complaining of pain in 0 the upper part of her abdomen and generalized itching. Her daughter has also noticed a yellowish discolouration of her skin. C 100 The symptoms started a week ago and are gradually getting a worse. You have been assigned her initial assessment... s Cases e 100 Cases in Surgery presents 100 scenarios requiring s surgical treatment commonly seen by medical students and i junior doctors in the emergency department or outpatient n clinic. A succinct summary of the patient’s history, examination S and initial investigations, including photographs where relevant, is u followed by questions on the diagnosis and management of each case. The answer includes a detailed discussion on each topic, with further illustration where r g appropriate, providing an essential revision aid as well as a practical guide for students and i e 100 n junior doctors. r Making speedy and appropriate clinical decisions, and choosing the best course of action to y take as a result, is one of the most important and challenging parts of training to become a S doctor. These true-to-life cases will teach students and junior doctors to recognize important Cases surgical conditions, and to develop their diagnostic and management skills. u Key features: r • S uccinct case studies presented in an easy-to-read format, listing patient history, g examination and investigations • Q uestions at the end of each case prompt readers to consider their options for diagnosis, e investigation and management • A nswer pages then guide readers through the clinician’s sequence of thoughts and actions r y • I llustrations, information boxes and key points summaries reinforce learning, ideal during exam revision • A broad range of common conditions is covered, from breast lumps to diabetic feet, in together with more unusual cases The author team: James A Gossage BSc MS FRCS, Consultant Upper Gastrointestinal Surgeon, Guy’s & St Thomas’ NHS Foundation Trust, London, UK eS de Bijan Modarai PhD FRCS, Senior Lecturer in Vascular Surgery/Consultant Vascular Surgeon, itco King’s College London/Guy’s & St Thomas’ NHS Foundation Trust, London, UK ion nd Arun Sahai BSc PhD FRCS, Consultant Urologist & Honorary Senior Lecturer, Department of Urology, Guy’s Hospital, MRC Center for Transplantation, King’s College London, G King’s Health Partners, London, UK S o a Richard Worth BSc MRCS MRCGP, GP principal with a specialist interest in Orthopaedics, h ss Surgery a a Jersey, UK i g a e Kevin G Burnand MS FRCS, Emeritus Professor of Vascular Surgery, King’s College London nd , M School of Medicine/Guy’s & St Thomas’ NHS Foundation Trust, London, UK W o 100 Cases Series Editor: or da Janice Rymer MD FRCOG FRANZCOG FHEA, Dean of Undergraduate Medicine and th ra Professor of Gynaecology, King’s College London School of Medicine, London, UK i, James A Gossage, Bijan Modarai, Arun Sahai and Richard Worth K17942 6000 Broken Sound Parkway, NW Suite 300, Boca Raton, FL 33487 ISBN: 978-1-4441-7427-4 90000 Volume Editor: Kevin G Burnand 711 Third Avenue an informa business New York, NY 10017 2 Park Square, Milton Park Series Editor: Janice Rymer www.crcpress.com Abingdon, Oxon OX14 4RN, UK 9 781444 174274 100 Cases in Surgery TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk 100 Cases in Surgery Second edition James A Gossage BSc MS FRCS Consultant Upper Gastrointestinal Surgeon, Guy’s and St Thomas’ NHS Foundation Trust, London, UK Bijan Modarai PhD FRCS Senior Lecturer in Vascular Surgery/Consultant Vascular Surgeon, King’s College London/Guy’s and St Thomas’ NHS Foundation Trust, London, UK Arun Sahai BSc PhD FRCS Consultant Urologist & Honorary Senior Lecturer, Department of Urology, Guy’s Hospital, MRC Centre for Transplantation, King’s College London, King’s Health Partners, London, UK Richard Worth BSc MRCS MRCGP GP principal with a specialist interest in Orthopaedics, Jersey, UK Volume Editor: Kevin G Burnand MS FRCS Emeritus Professor of Vascular Surgery, King’s College London School of Medicine/Guy’s and St Thomas’ NHS Foundation Trust, London, UK 100 Cases Series Editor: Janice Rymer MD FRCOG FRANZCOG FHEA Dean of Undergraduate Medicine and Professor of Gynaecology, King’s College London School of Medicine, London, UK Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2014 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20131003 International Standard Book Number-13: 978-1-4441-7428-1 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guid- ance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, pro- cedures or diagnoses should be independently verified. The reader is strongly urged to consult the drug companies’ printed instructions, and their websites, before administering any of the drugs recommended in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com CONTENTS Preface vii Abbreviations ix 1. General and colorectal 1 2. Upper gastrointestinal 43 3. Breast and endocrine 85 4. Vascular 97 5. Urology 129 6. Orthopaedic 149 7. Ear, nose and throat 191 8. Neurosurgery 199 9. Anaesthesia 207 10. Postoperative complications 217 Index 229 TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk PREFACE We hope this book will give a good introduction to common surgical conditions seen in everyday surgical practice. Each question has been followed up with a brief overview of the condition and its immediate management. The book should act as an essential revision aid for surgical finals and as a basis for practising surgery after qualification. I would like to thank my co-authors for all their help and expertise in each of the surgical specialties. I would also like to thank the following people for their help with illustrations: Professor KG Burnand, Mr MJ Forshaw, Mr M Reid and Mr A Liebenberg. James A Gossage TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk ABBREVIATIONS ABPI ankle–brachial pressure index ACTH adrenocorticotrophic hormone ALP alkaline phosphatase AP anterior-posterior APTT activated partial thromboplastin time ASA American Society of Anesthesiologists AST aspartate transaminase ATLS Advanced Trauma and Life Support BMI body mass index BNF British National Formulary BPH benign prostatic hyperplasia CBD common bile duct CEA carcinoembryonic antigen COPD chronic obstructive pulmonary disease CRP C-reactive protein CSDH chronic subdural haematoma CT computerized tomography DVT deep vein thrombosis ECG electrocardiogram EMG electromyogram ENT ear, nose and throat ERCP endoscopic retrograde cholangiopancreatography ESR erythrocyte sedimentation rate EUA examination under anaesthesia FAST focused abdominal sonographic technique FEV forced expiratory volume in one second 1 FNAC fine needle aspiration cytology FVC forced vital capacity GCS Glasgow Coma Score GGT gamma-glutamyl transferase GP general practitioner Hb haemoglobin HbS haemoglobin S HCG human chorionic gonadotropin HDU high-dependency unit HiB Haemophilus influenzae type B ICU intensive care unit IgA immunoglobulin A INR international normalized ratio IPSS International Prostate Symptom Score ISAT International Subarachnoid Aneurysm Trial IVU intravenous urethrogram KUB kidney, ureter, bladder LATS long-acting thyroid stimulator LDH lactate dehydrogenase
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